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Report Slams V.A. Doctor For Dismissing Suicide Risk of Patient Who Later Killed Himself

2020-07-28 16:22:30
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WASHINGTON — The internal watchdog for the Department of Veterans Affairs said Tuesday that a veteran who came through the department’s medical center in Washington last year seeking psychiatric treatment died by suicide a few days later, after a doctor there ordered him forcibly removed and was heard saying that she did “not care” if he killed himself.

The report, which details many failings at a center that has been the subject of repeated criticism, comes a few weeks after Robert L. Wilkie, the secretary of veterans affairs, told a conservative media outlet that “President Trump is the first president since the 1890s who recognized the scourge of veteran suicide.”

The number of veterans who die by suicide is roughly 20 a day, about one and a half times more often than those who have not served in the military.

But even as the department struggles to lower those numbers, the case at the Washington D.C. V.A. Medical Center last year appears egregious. A patient in his 60s, who had a long history of panic attacks, pain killer addiction and various injuries came into the hospital’s emergency room.

He described pain from drug withdrawal and insomnia, and asked to be admitted for detoxification. An outpatient psychiatrist assessed him as being at “moderate risk for suicide” and recommended he be admitted. He was sent back to the emergency room.

Later, a consulting psychiatry resident, who said the patient could be served in outpatient care, recommended he be discharged and sent home, but the patient refused to leave, according to the inspector general report.

Police from the department were called to escort him out, and at least three hospital staff members said they heard the doctor say that veterans “can go shoot themselves. I do not care.”

The man died six days later from a self-inflicted gunshot wound.

The inspector general report found many missteps in the patient’s care, including communications breakdowns between staff members, and that the “Emergency Department and consulting psychiatry staff failed to complete required suicide prevention planning prior to the patient’s discharge.”

“Emergency Department staff’s failure to manage this patient’s care, according to Veteran Health Administration suicide prevention policies, contributed to an inadequate assessment of suicide risk,” the report stated.

According to the report, the actions “could also be considered misconduct according to V.A. policy and patient abuse according to facility policy.”

The doctor, who was not named in the report, worked at the veterans center through a contact with the George Washington University Hospital, an arrangement that is common across veterans medical care. The report faults the center for not moving to immediately discipline or remove the doctor, who “had a history of verbal misconduct.”

The hospital in the nation’s capital has come under fire before from Michael J. Missal, the veterans’ department inspector general.

In 2018, he cited poor management and other factors, which included a lack of medical supplies, less-than-sterile conditions and chronic understaffing. Last year, a senior policy adviser on female veterans issues on Capitol Hill said she was assaulted at the center in Washington by a man who slammed his body against hers and then pressed himself against her in the center’s cafe. That incident remains the subject of investigation by Mr. Missal’s office.

Since the suicide, officials at the hospital told the inspector general they have “instituted a comprehensive educational program for clinical staff working in the Emergency Room to ensure staff’s understanding of the Veterans Health Administration’s local policies surrounding suicide prevention.”

The doctor was removed several months after the incident.

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